title: Intracerebral hemorrhage after thrombolytic therapy in acute ischemic stroke patients with renal dysfunction.
abstract: OBJECTIVE
  One complication of thrombolysis is intracranial hemorrhage (ICH). We investigated whether treatment with tissue plasminogen activator (t-PA) for ischemic infarction results in a higher risk of ICH in patients with kidney dysfunction, who are predisposed to treatment complications due to their bleeding tendency.
  
  
  METHODS
  A total of 297 patients given thrombolytic therapy for ischemic stroke were classified into 2 groups on the basis of their estimated renal glomerular filtration rate (eGFR). The outcome measures included the incidence of ICH and modified Rankin scale scores at 1 month and 1 year.
  
  
  RESULTS
  ICH was more common in the renal dysfunction group (23 vs. 12.5%). Nevertheless, multivariate logistic regression showed that the odds of ICH were not high in the group with low eGFR. Also, eGFR values <60 ml/min/1.73 m(2) did not predict the odds for functional dependence or death at 1 month and 1 year.
  
  
  CONCLUSIONS
  After adjusting for confounding factors, the odds ratio for ICH was not higher in intravenous t-PA-treated stroke patients with renal dysfunction. A trend to the occurrence of ICH among these patients, however, was noted. Renal dysfunction does not predict the odds for functional dependence or death at 1 month and 1 year.
authors.affiliation: Department of Neurology, Cardinal Tien Hospital, New Taipei City, Taiwan, ROC.
authors.forename: Tzu-Hao
authors.initials: TH
authors.lastname: Chao
authors.forename: Ting-Chun
authors.initials: TC
authors.lastname: Lin
authors.forename: Yao
authors.initials: Y
authors.lastname: Shieh
authors.forename: Ting-Yu
authors.initials: TY
authors.lastname: Chang
authors.forename: Kuo Lun
authors.initials: KL
authors.lastname: Hung
authors.forename: Chi-Hung
authors.initials: CH
authors.lastname: Liu
authors.forename: Tsong Hai
authors.initials: TH
authors.lastname: Lee
authors.forename: Yeu Jhy
authors.initials: YJ
authors.lastname: Chang
authors.forename: Jiann Der
authors.initials: JD
authors.lastname: Lee
authors.forename: Chien Hung
authors.initials: CH
authors.lastname: Chang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy*; D002543:Cerebral Hemorrhage / Q000209:etiology*; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects; D010959:Tissue Plasminogen Activator / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator